MON-854 - Association of Blood Glucose Levels and Glycemic Variability on All-Cause Mortality Among Patients Admitted at Intensive Care Unit in A Tertiary Hospital: A Retrospective Study

Background and Objectives. Dysglycemia – including hyperglycemia, hypoglycemia, and increased glycemic variability (GV) – is common among critically ill patients and has been associated with adverse outcomes. This study aimed to determine the association of blood glucose levels and glycemic variability with all-cause mortality among patients admitted to the intensive care unit (ICU) of a tertiary hospital.

Methodology. This retrospective cross-sectional study reviewed 251 adult ICU patients admitted from January 2022 to December 2024. Capillary blood glucose (CBG) measurements were used to compute mean glucose levels and GV indices, including standard deviation (SD), coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE). Clinical and glycemic characteristics were compared between survivors and non-survivors using appropriate statistical tests. Binary logistic regression with stepwise selection identified independent predictors of mortality.
Results. Of the 251 patients, 165 (66%) expired and 86 (34%) survived. Non-survivors had significantly higher mean blood glucose levels (median 140.38 mg/dL, IQR 122–163.5) compared with survivors (median 123.92 mg/dL, IQR 114–143.62; p < 0.001). Glycemic variability was greater among non-survivors as measured by SD (median 35.21, IQR 25–50; p = 0.001), CV (median 0.26, IQR 0.19–0.32; p = 0.028), and MAGE (median 68.67, IQR 49–103.57; p = 0.004). Intubation was more frequent among those who expired (49.09%; p < 0.001), and septic shock and acute respiratory failure were predominant reasons for ICU admission (p < 0.001). Median length of stay was shorter among expired patients (7 vs. 10.5 days, p < 0.001). In multivariate analysis, septic shock (AOR 8.37, 95% CI 2.79–25.08; p < 0.001), intubation (AOR 5.18, 95% CI 2.63–10.20; p < 0.001), and higher average capillary blood glucose (AOR 1.01 per mg/dL increase, 95% CI 1.004–1.02; p = 0.007) remained independent predictors of mortality.

Conclusion. Septic shock, need for mechanical ventilation, and sustained hyperglycemia were the strongest independent predictors of mortality among ICU patients. Although glycemic variability indices were not independently predictive after adjustment, their strong univariate associations and consistent support in the literature suggest their value as indicators of physiologic instability and potential targets for early intervention. These findings reinforce the importance of timely sepsis management and optimized glycemic control to improve outcomes in critically ill patients.

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